AJIC: American Journal of Infection Control
Volume 33, Issue 2 , Pages 67-77 , March 2005

Comparative efficacy of hand hygiene agents in the reduction of bacteria and viruses

  • Emily E. Sickbert-Bennett, MS

      Affiliations

    • From the Department of Hospital Epidemiology, University of North Carolina Health Care System
    • Department of Environmental Sciences and Engineering, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
    • Corresponding Author InformationEmily E. Sickbert-Bennett, MS, Hospital Epidemiology, 1001 West Wing, CB 7600, 101 Manning Drive, Chapel Hill, NC 27514
    • ,
  • David J. Weber, MD, MPH

      Affiliations

    • From the Department of Hospital Epidemiology, University of North Carolina Health Care System
    • Corresponding Author InformationReprint requests: David J. Weber, MD, MPH, CB 7030, 130 Mason Farm Road, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7030.
    • ,
  • Maria F. Gergen-Teague, MT(ASCP)

      Affiliations

    • From the Department of Hospital Epidemiology, University of North Carolina Health Care System
    • ,
  • Mark D. Sobsey, PhD

      Affiliations

    • Department of Environmental Sciences and Engineering, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
    • ,
  • Gregory P. Samsa, PhD

      Affiliations

    • Department of Biostatistics and Bioinformatics, Duke University Medical School, Durham, North Carolina
    • ,
  • William A. Rutala, PhD, MPH

      Affiliations

    • From the Department of Hospital Epidemiology, University of North Carolina Health Care System

References 

  1. Semmelweis I. Etiology, concept, and prophylaxis of childbed fever. In:  Carter KC editors. 1st ed.. Madison, WI: The University of Wisconsin Press; 1983;
  2. Larson EL, Early E, Cloonan P, Sugrue S, Parides M. An organizational climate intervention associated with increased handwashing and decreased nosocomial infections. Behav Med. 2000;26:14–22
  3. Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, et al. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Lancet. 2000;356:1307–1312
  4. Niffenegger JP. Proper handwashing promotes wellness in child care. J Pediatr Health Care. 1997;11:26–31
  5. Roberts L, Jorm L, Patel M, Smith W, Douglas RM, McGilchrist C. Effect of infection control measures on the frequency of diarrheal episodes in child care: a randomized, controlled trial. Pediatrics. 2000;105:743–746
  6. Shahid NS, Greenough WB, Samadi AR, Huq MI, Rahman N. Hand washing with soap reduces diarrhoea and spread of bacterial pathogens in a Bangladesh village. J Diarrhoeal Dis Res. 1996;14:85–89
  7. Wilson JM, Chandler GN, Muslihatun , Jamiluddin . Hand-washing reduces diarrhoea episodes: a study in Lombok, Indonesia. Trans R Soc Trop Med Hyg. 1991;85:819–821
  8. Aly R, Maibach H. Comparative study on the antimicrobial effect of 0.5% chlorhexidine gluconate an 70% isopropyl alcohol on the normal flora of the hands. Appl Environ Microbiol. 1979;37:610–613
  9. Ayliffe GAJ, Babb JR, Davies JG, Lilly HA. Hand disinfection: a comparison of various agents in laboratory and ward studies. J Hosp Infect. 1988;11:226–243
  10. Bartzokas CA, Gibson MF, Graham R, Pinder DC. A comparison of triclosan and chlorhexidine preparations with 60% isopropyl alcohol for hygienic hand disinfection. J Hosp Infect. 1983;4:245–255
  11. Butz AM, Laughon BE, Gullette DL, Larson EL. Alcohol-impregnated wipes as an alternative in hand hygiene. Am J Infect Control. 1990;18:70–76
  12. Davies JG, Babb JR, Bradley CR, Ayliffe GAJ. Preliminary study of test methods to assess the virucidal activity of skin disinfectants using poliovirus and bacteriophages. J Hosp Infect. 1993;25:125–131
  13. Eggers HJ. Experiments on antiviral activity of hand disinfectants: some theoretical and practical considerations. Zbl Bakt. 1990;273:36–51
  14. Kampf G, Jarosch R, Rüden H. Limited effectiveness of chlorhexidine based hand disinfectants against methicillin-resistant Staphylococcus aureus (MRSA). J Hosp Infect. 1998;38:297–303
  15. Larson EL, Aiello AE, Bastyr J, Lyle C, Stahl J, Cronquist A, et al. Assessment of two hand hygiene regimens for intensive care unit personnel. Crit Care Med. 2001;29:944–951
  16. Larson EL, Laughon BE. Comparison of four antiseptic products containing chlorhexidine gluconate. Antimicrob Agents Chemother. 1987;31:1572–1574
  17. Larson EL, Eke PI, Laughon BE. Efficacy of alcohol-based hand rinses under frequent-use conditions. Antimicrob Agents Chemother. 1986;30:542–544
  18. Minakuchi K, Yamamoto Y, Matsunaga K, Hayata M, Yasuda T, Katsuno Y, et al. The antiseptic effect of a quick drying rubbing type povidone-iodine alcoholic disinfectant solution. Postgrad Med J. 1993;69:S23–S26
  19. Rosenberg A, Alatary SD, Peterson AF. Safety and efficacy of the antiseptic chlorhexidine gluconate. Surg Gynecol Obstet. 1976;143:789–792
  20. Schürmann W, Eggers HJ. An experimental study on the epidemiology of enteroviruses: water and soap washing of poliovirus 1–contaminated hands, its effectiveness and kinetics. Med Microbiol Immunol. 1985;174:221–236
  21. Schürmann W, Eggers HJ. Antiviral activity of an alcoholic hand disinfectant: comparison of the in vitro suspension test with in vivo experiments on hands, and on individual fingertips. Antivir Res. 1983;3:25–41
  22. Ulrich JA. Clinical study comparing hibistat (0.5% chlorhexidine gluconate in 70% isopropyl alcohol) and betadine surgical scrub (7.5% povidone-iodine) for efficacy against experimental contamination of human skin. Curr Ther Res. 1982;31:27–30
  23. Woolwine JD, Gerberding JL. Effect of testing method on apparent activities of antiviral disinfectants and antiseptics. Antimicrob Agents Chemother. 1995;39:921–923
  24. Boyce JM, Pittet D. Centers for Disease Control and Prevention. Guideline for hand hygiene in health-care settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Am J Infect Control. 2002;30:S1–S46
  25. Sickbert-Bennett EE, Weber DJ, Gergen-Teague MF, Rutala WA. The effects of test variables on the efficacy on hand hygiene agents. Am J Infect Control. 2004;32:69–83
  26. American Society for Testing Materials . Standard test method for evaluation of healthcare personnel handwash formulation. West Conshohocken, PA: American Society Testing Materials; 1994;
  27. Adams MH. Bacteriophages. New York: Interscience Publishers, Inc; 1959;
  28. Shin G-A, Sobsey MD. Reduction of Norwalk virus, poliovirus 1, and bacteriophage MS2 by ozone disinfection of water. Appl Environ Microbiol. 2003;69:3975–3978
  29. Benson L, Bush L, LeBlanc D. Importance of neutralizers in the stripping fluid in a simulated healthcare personnel handwash. Infect Control Hosp Epidemiol. 1990;11:595–599
  30. American Society for Testing Materials . Practices for evaluation inactivators of antimicrobial agents used in disinfectant, sanitizer, antiseptic or preserved products. West Conshohocken, PA: American Society Testing Materials; 1991;
  31. Burke JP. Infection control–a problem for patient safety. N Engl J Med. 2003;348:651–656
  32. Weist K, Pollege K, Schulz I, Rüden H, Gastmeier P. How many nosocomial infections are associated with cross-transmission: a prospective cohort study in a surgical intensive care unit. Infect Control Hosp Epidemiol. 2002;23:127–132
  33. Valenti WM, Menegus MA, Hall CB, Pincus PH, Douglas RG. Nosocomial viral infections: I. epidemiology and significance. Infect Control. 1980;1:33–37
  34. Slinger R, Dennis P. Nosocomial influenza at a canadian pediatric hospital from 1995 to 1999: opportunities for prevention. Infect Control Hosp Epidemiol. 2002;23:627–629
  35. Heerens AT, Marshall DD, Bose CL. Nosocomial respiratory syncytial virus: a threat in the modern neonatal intensie care unit. J Perinatol. 2002;22:306–307
  36. Widdowson MA, van Doornum GJ, van der Poel WH, de Boer AS, van de Heide R, Mahdi U, et al. An outbreak of diarrhea in a neonatal medium care unit caused by a novel strain of rotavirus: investigation using both epidemiologic and microbiological methods. Infect Control Hosp Epidemiol. 2002;23:665–670
  37. Caspari G, Wassill H. Nosocomial virus infections in the eye. Dev Ophthalmol. 2002;33:207–209
  38. McCall J, Smithson R. Rapid response and strict control measures can contain a hospital outbreak of Norwalk-like virus. Commun Dis Public Health. 2002;5:243–246
  39. Petrosillo N, Raffaele B, Martini L, Nicastri E, Nurra G, Anzidei G, et al. A nosocomial and occupational cluster of hepatitis a virus infection in a pediatric ward. Infect Control Hosp Epidemiol. 2002;23:343–345
  40. Wong T, Lee C, Tam W, Lau J, Yu T, Lui S, et al. Cluster of SARS among medical students exposed to single patient, Hong Kong. Emerg Infect Dis. 2004;10:269–276
  41. Zaragoza M, Sallés M, Gomez J, Bayas JM, Trilla A. Handwashing with soap or alcoholic solutions: a randomized clinical trial of its effectiveness. Am J Infect Control. 1999;27:258–261
  42. Marena C, Lodol L, Zecca M, Bulgheroni A, Carretto E, Maserati R, et al. Assessment of handwashing practices with chemical and microbiologic methods: preliminary results from a prospective crossover study. Am J Infect Control. 2002;30:334–340
  43. Fendler EJ, Ali Y, Hammond BS, Lyons MK, Kelley MB, Vowell NA. The impact of alcohol hand sanitizer use on infection rates in an extended care facility. Am J Infect Control. 2002;30:226–233
  44. Doebbeling BN, Stanley GL, Sheetz CT, Pfaller MA, Houston AK, Annis L, et al. Comparative efficacy of alternative hand-washing agents in reducing nosocomial infections in intensive care units. N Engl J Med. 1992;327:88–93
  45. Ayliffe GAJ, Babb JR, Quoraishi AH. A test for “hygienic” hand disinfection. J Clin Pathol. 1978;31:923–928
  46. Dharan S, Hugonnet S, Sax H, Pittet D. Comparison of waterless hand antisepsis agents at short application times: raising the flag of concern. Infect Control Hosp Epidemiol. 2003;24:160–164
  47. Graham M. Frequency and duration of handwashing in and intensive care unit. Am J Infect Control. 1990;18:77–80
  48. Bischoff WE, Reynolds TM, Sessler CN, Edmond MB, Wenzel RP. Handwashing compliance by health care workers: the impact of introducing an accessible, alcohol-based hand antiseptic. Arch Intern Med. 2000;160:1017–1021
  49. Mody L, McNeil SA, Sun R, Bradley SF, Kauffman CA. Introduction of a waterless alcohol-based handrub in a long-term-care facility. Infect Control Hosp Epidemiol. 2003;24:165–171
  50. Hugonnet S, Perneger TV, Pittet D. Alcohol-based handrub improves compliance with hand hygiene in intensive care units. Arch Intern Med. 2002;162:1037–1050
  51. McDonald LC. Hand hygiene in the new millennium: drawing the distinction between efficacy and effectiveness. Infect Control Hosp Epidemiol. 2003;24:157–159
  52. Boyce JM, Larson EL, Weinstein RA. Alcohol-based hand gels and hand hygiene in hospitals. Lancet. 2002;360:1509–1510
  53. Sattar SA, Springthorpe VS, Tetro J, Vashon R, Keswick B. Hygienic hand antiseptics: should they not have activity and label claims against viruses. Am J Infect Control. 2002;30:355–372
  54. Gotz H, de JB, Lindback J, Parment PA, Hedlund KO, Torven M, et al. Epidemiological investigation of a food-borne gastroenteritis outbreak caused by norwalk-like virus in 30 day-care centres. Scand J Infect Dis. 2002;34:115–121
  55. Chitambar SD, Chadha MS, Yeolekar LR, Arankalle VA. Hepatitis A in day care centre. Indian J Pediatr. 1996;63:781–783
  56. Klein M, DeForest A. Antiviral action of germicides. Soap and Chemical Specialties. 1963;39:70–7295-97
  57. Klein M, DeForest A. Principles of viral inactivity. In:  Block SS editors. Disinfection, Sterilization, and Preservation. 3rd ed.. Philadelphia: Lea & Febiger; 1983;p. 422–434
  58. Jones MV, Bellamy K, Alcock R, Hudson R. The use of bacteriophage MS2 as a model system to evaluate virucidal hand disinfectants. J Hosp Infect. 1991;17:279–285

 Supported by the UNC Health Care System and the NC Statewide Program in Infection Control and Epidemiology.

PII: S0196-6553(04)00587-5

doi: 10.1016/j.ajic.2004.08.005

AJIC: American Journal of Infection Control
Volume 33, Issue 2 , Pages 67-77 , March 2005

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